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This Parental Permission and Medical Consent With Liability Release allows a parent to give consent for a child to participate in an activity which is defined within the form. Having this form on hand allows organisers of an activity to deal with any type of emergency involving a child when a parent may not be readily available. This form also releases the organiser of the activity from any liability in the event of injury or damage. A parent can also revoke this document at any time.

This lawyer-prepared packet contains:

Instructions and Checklist

General Information

Parental Permission and Medical Consent With Liability Release for use in India

Law Compliance: This form complies with the laws of the states and territories of India

This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.

Parental Permission and Medical Consent

With Liability Release

(India)

This Packet Includes:

1. Instructions and Checklist

2. General Information

3. Parental Permission and Medical Consent With

Liability Release

Instructions and Checklist

Parental Permission and Medical Consent

With Liability Release

Either one or both Parents can sign the Parental Permission and Medical Consent with Liability Release.

The original Parental Permission and Medical Consent With Liability Release and Child Care Instructions document should be given to the organisers of the activity the child will be participating in.

The Parents should keep copies of the Parental Permission and Medical Consent with Liability Release and Child Care Instructions document for their records.

These forms are not intended and are not a substitute for legal advice. These forms should only be a starting point for you and should not be used without consulting with a lawyer first.

The purchase and use of these forms, is subject to the Disclaimers and Terms of Use found at www.findlegalforms.com

General Information

Parental Permission and Medical Consent

With Liability Release

It sometimes is necessary for parents to (a) give their permission so that their child can participate in some form of organised activity (i.e. a school trip, excursion, scouting trip, sports team etc…) and to (b) release the organiser of the activity from liability.

A “Parental Permission and Medical Consent With Liability Release” Form allows parents to give consent for their child to participate in a specified activity as defined in the form. This form also grants the organisers of the activity the power to make health care related decisions on behalf of the child.

By having this type of document available, the organisers of the activity will be able to better deal with any types of emergency involving the children and can avoid potential problems when, for example, arranging for medical, dental or any other type of care. This can be especially important on a school or scouting trip if a medical emergency arises when the parents may not be readily available to consent to certain emergency medical procedures. Medical personnel will also generally feel more comfortable dealing with someone who can provide this type of document.

The Permission and Medical Consent with Liability Release Form also releases the organiser of the activity from any liability, holds them harmless and indemnifies them in the event of injury or damage.

Although the Parental Permission and Medical Consent have a beginning and an “end/expiration” date, the Parent(s) can revoke the document at any time even before the ending date.

Please note that this information is not intended as and is not a substitute for legal advice. Furthermore, this information is general information that is not state specific.

DISCLAIMER:

FindLegalForms, Inc. (“FLF”) is not a law firm and does not provide legal advice. The use of these materials is not a substitute for legal advice. Only a lawyer can provide legal advice. A lawyer should be consulted for all serious legal matters. No Lawyer-Client relationship is created by use of these materials.

THESE MATERIALS ARE PROVIDED “AS-IS.” FLF DOES NOT GIVE ANY EXPRESS OR IMPLIED WARRANTIES OF MERCHANTABILITY, SUITABILITY OR COMPLETENESS FOR ANY OF THE MATERIALS FOR YOUR PARTICULAR NEEDS. THE MATERIALS ARE USED AT YOUR OWN RISK. IN NO EVENT WILL: I) FLF, ITS AGENTS, PARTNERS, OR AFFILIATES; OR II) THE PROVIDERS, AUTHORS OR PUBLISHERS OF ITS MATERIALS, BE RESPONSIBLE OR LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES (INCLUDING, BUT NOT LIMITED TO, PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES; LOSS OF USE, DATE OR PROFITS; OR BUSINESS INTERRUPTION) HOWEVER USED AND ON ANY THEORY OF LIABILITY, WHETHER IN CONTRACT, STRICT LIABILITY, OR TORT (INCLUDING NEGLIGENCE OR OTHERWISE) ARISING IN ANY WAY OUT OF THE USE OF THESE MATERIALS.

PARENTAL PERMISSION AND MEDICAL CONSENT WITH LIABILITY RELEASE

RE:

Name: _________________________________ born on __________________________

The undersigned(s) being the lawful parent(s) and/or guardian(s) of the above child (the "Child"), hereby consents to the participation by the Child in __________________________ (describe activity) conducted by ______________________________________________ (Name of “Organiser") and to the participation of the Child in all events relating to the activity on _______________ through _______________.

The undersigned hereby further authorise(s) any of the staff, employees, agents and representatives of Organiser to provide for, approve and authorise any health care at any hospital, emergency room, doctor’s office or other institution; employ any physicians, dentists, nurses, or other person whose services may be needed for such health care; review and if necessary disclose the contents of any medical records; execute any consent form required by medical, dental or other health authorities incident to the provision of medical, surgical or dental care to the child. Health care shall include but not be limited to the administration of anaesthesia, X-ray examination, performance of operations, diagnostic and other procedures.

If there is no medical emergency, the guardian will first use reasonable efforts to contact the parent(s) and/or guardian(s) before administering or authorizing any treatment.

Notwithstanding other provisions in this Consent Form, Organisershall not have the authority to withhold or withdraw life-sustaining procedures for the Child.

The undersigned assume(s) all risk of injury or harm to the Child associated with participation in the Activity and agree(s) to releases, indemnify, defend and forever discharge the Organiser and its staff, employees and agents (collectively the "Organiser") of and from all liability, claims, demands, damages, costs, expenses, actions and causes of action (collectively the "Claims") in respect of death, injury, loss or damage to the Child or by the Child, howsoever caused, arising or to arise by reason of or during the Child's participation in the Activity.

This Consent Form may be revoked at any time before the expiration date with written notice to Organiser.

Signed on ________________ (date), at _______________ (city), _______________ (state).

________________________________

Signature of Parent

________________________________

Signature of Parent

Child Care Information and Instructions

Child's Name:

Child's Nickname:

Child's Age:

Parent(s) and Other Contacts

Mother’s Name:

Father’s Name:

Address of Parent(s):

Home#

Work#

Second Contact Name:

Relationship:

Phone Number:

Third Contact Name:

Relationship:

Phone Number:

Medical/Health/Insurance Care Information

Child’s Doctor Name:

Address:

Office Telephone:

After Hours Number:

Health Insurance Company:

Group or Policy Number:

Telephone Number:

Medications:

Allergies:

Immunisations:

Special Conditions:

Schedule & Instructions

Meals: __________________________

Snacks: _________________________

Naps: __________________________

Bedtime: _______________________

Other: _________________________

Habits and Rules

Number of Pages6

DimensionsDesigned for Letter Size (8.5" x 11")

EditableYes (.doc, .wpd and .rtf)

UsageUnlimited number of prints

Product number#33982

This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.

Parental Permission and Medical Consent

With Liability Release

(India)

This Packet Includes:

1. Instructions and Checklist

2. General Information

3. Parental Permission and Medical Consent With

Liability Release

Instructions and Checklist

Parental Permission and Medical Consent

With Liability Release

Either one or both Parents can sign the Parental Permission and Medical Consent with Liability Release.

The original Parental Permission and Medical Consent With Liability Release and Child Care Instructions document should be given to the organisers of the activity the child will be participating in.

The Parents should keep copies of the Parental Permission and Medical Consent with Liability Release and Child Care Instructions document for their records.

These forms are not intended and are not a substitute for legal advice. These forms should only be a starting point for you and should not be used without consulting with a lawyer first.

The purchase and use of these forms, is subject to the Disclaimers and Terms of Use found at www.findlegalforms.com

General Information

Parental Permission and Medical Consent

With Liability Release

It sometimes is necessary for parents to (a) give their permission so that their child can participate in some form of organised activity (i.e. a school trip, excursion, scouting trip, sports team etc…) and to (b) release the organiser of the activity from liability.

A “Parental Permission and Medical Consent With Liability Release” Form allows parents to give consent for their child to participate in a specified activity as defined in the form. This form also grants the organisers of the activity the power to make health care related decisions on behalf of the child.

By having this type of document available, the organisers of the activity will be able to better deal with any types of emergency involving the children and can avoid potential problems when, for example, arranging for medical, dental or any other type of care. This can be especially important on a school or scouting trip if a medical emergency arises when the parents may not be readily available to consent to certain emergency medical procedures. Medical personnel will also generally feel more comfortable dealing with someone who can provide this type of document.

The Permission and Medical Consent with Liability Release Form also releases the organiser of the activity from any liability, holds them harmless and indemnifies them in the event of injury or damage.

Although the Parental Permission and Medical Consent have a beginning and an “end/expiration” date, the Parent(s) can revoke the document at any time even before the ending date.

Please note that this information is not intended as and is not a substitute for legal advice. Furthermore, this information is general information that is not state specific.

DISCLAIMER:

FindLegalForms, Inc. (“FLF”) is not a law firm and does not provide legal advice. The use of these materials is not a substitute for legal advice. Only a lawyer can provide legal advice. A lawyer should be consulted for all serious legal matters. No Lawyer-Client relationship is created by use of these materials.

THESE MATERIALS ARE PROVIDED “AS-IS.” FLF DOES NOT GIVE ANY EXPRESS OR IMPLIED WARRANTIES OF MERCHANTABILITY, SUITABILITY OR COMPLETENESS FOR ANY OF THE MATERIALS FOR YOUR PARTICULAR NEEDS. THE MATERIALS ARE USED AT YOUR OWN RISK. IN NO EVENT WILL: I) FLF, ITS AGENTS, PARTNERS, OR AFFILIATES; OR II) THE PROVIDERS, AUTHORS OR PUBLISHERS OF ITS MATERIALS, BE RESPONSIBLE OR LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES (INCLUDING, BUT NOT LIMITED TO, PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES; LOSS OF USE, DATE OR PROFITS; OR BUSINESS INTERRUPTION) HOWEVER USED AND ON ANY THEORY OF LIABILITY, WHETHER IN CONTRACT, STRICT LIABILITY, OR TORT (INCLUDING NEGLIGENCE OR OTHERWISE) ARISING IN ANY WAY OUT OF THE USE OF THESE MATERIALS.

PARENTAL PERMISSION AND MEDICAL CONSENT WITH LIABILITY RELEASE

RE:

Name: _________________________________ born on __________________________

The undersigned(s) being the lawful parent(s) and/or guardian(s) of the above child (the "Child"), hereby consents to the participation by the Child in __________________________ (describe activity) conducted by ______________________________________________ (Name of “Organiser") and to the participation of the Child in all events relating to the activity on _______________ through _______________.

The undersigned hereby further authorise(s) any of the staff, employees, agents and representatives of Organiser to provide for, approve and authorise any health care at any hospital, emergency room, doctor’s office or other institution; employ any physicians, dentists, nurses, or other person whose services may be needed for such health care; review and if necessary disclose the contents of any medical records; execute any consent form required by medical, dental or other health authorities incident to the provision of medical, surgical or dental care to the child. Health care shall include but not be limited to the administration of anaesthesia, X-ray examination, performance of operations, diagnostic and other procedures.

If there is no medical emergency, the guardian will first use reasonable efforts to contact the parent(s) and/or guardian(s) before administering or authorizing any treatment.

Notwithstanding other provisions in this Consent Form, Organisershall not have the authority to withhold or withdraw life-sustaining procedures for the Child.

The undersigned assume(s) all risk of injury or harm to the Child associated with participation in the Activity and agree(s) to releases, indemnify, defend and forever discharge the Organiser and its staff, employees and agents (collectively the "Organiser") of and from all liability, claims, demands, damages, costs, expenses, actions and causes of action (collectively the "Claims") in respect of death, injury, loss or damage to the Child or by the Child, howsoever caused, arising or to arise by reason of or during the Child's participation in the Activity.

This Consent Form may be revoked at any time before the expiration date with written notice to Organiser.

Signed on ________________ (date), at _______________ (city), _______________ (state).

________________________________

Signature of Parent

________________________________

Signature of Parent

Child Care Information and Instructions

Child's Name:

Child's Nickname:

Child's Age:

Parent(s) and Other Contacts

Mother’s Name:

Father’s Name:

Address of Parent(s):

Home#

Work#

Second Contact Name:

Relationship:

Phone Number:

Third Contact Name:

Relationship:

Phone Number:

Medical/Health/Insurance Care Information

Child’s Doctor Name:

Address:

Office Telephone:

After Hours Number:

Health Insurance Company:

Group or Policy Number:

Telephone Number:

Medications:

Allergies:

Immunisations:

Special Conditions:

Schedule & Instructions

Meals: __________________________

Snacks: _________________________

Naps: __________________________

Bedtime: _______________________

Other: _________________________

Habits and Rules

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